Repair of a cerebrospinal fluid fistula using a muscle pedicle flap: technical case report

Neurosurgery
Seung-Jae HyunYoung-Shin Ra

Abstract

As a late complication of radiation therapy and a transoral approach, a cerebrospinal fluid (CSF) fistula between an oropharyngeal cavity and the ventral dura of the cervical spine is an extremely rare event. There are often difficulties in repairing ventral dural defects. Herein, we describe a technique that assists in feasible repair of a CSF fistula associated with ventral dural defects. A 36-year-old man was admitted to our institution with postnasal drip and a progressive spastic gait disturbance. Eleven years earlier, he had a recurrent chordoma of the cervical spine, which was treated by 5 open surgeries, including a transoral operation, and 6 rounds of radiation therapy. A neuroradiological examination revealed a CSF fistula between a posterior pharyngeal wall and the ventral dura of the cervical spine. We performed a repair operation of the CSF fistula using a conventional direct posterior approach. However, we were unable to repair the fistula using a dural-substitute suturing procedure. Therefore, we used a semispinalis cervicis muscle pedicle flap. The muscle pedicle flap was brought through the dural defect in the anterior part of the posterior pharyngeal wall, to which it was fixed. It was then used to reinforce t...Continue Reading

References

Feb 1, 1988·Neurosurgery·M N HadleyP C Johnson
Dec 1, 1970·The Annals of Thoracic Surgery·F D Loop, L K Groves
Nov 24, 1999·Annals of Plastic Surgery·J HochbergR M Conrado

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Citations

Feb 13, 2016·Neurosurgical Review·Wael Mohamed Mohamed Moussa, Hisham A Aboul-Enein
Nov 19, 2013·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Trevor E TreasureRobert D Gear
Aug 5, 2015·Asian Spine Journal·Jason Pui Yin CheungKeith Dip Kei Luk
Dec 22, 2010·Current Opinion in Allergy and Clinical Immunology

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